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I have many conversations about diet and exercise here at the office, often after the person to whom I’m talking has been told they have “insulin resistance” and should start some new medication.

But when I ask if anyone explained what insulin resistance is, the answer is almost always no. And knowing, as they say, is half the battle. So, allow me to explain.

Insulin is a storage hormone. It’s made in the pancreas, the organ that senses increases in blood sugar, which triggers insulin to be released to tell that blood sugar (glucose) to be stored (the storage form of glucose is called glycogen).

There are two places where glucose is stored: the liver and your muscles.

To explain insulin resistance, I compare those two storage areas to hotel parking lots. Cars enter the freeway (glucose enters the bloodstream), and the traffic cop (the pancreas) wants them off the street and parked.

But you’ll run out of parking space if there are too many cars. The traffic cops still won’t like all the traffic, so they’ll keep directing cars into the lot. The hotels won’t like all the extra traffic, so at first, they’ll turn on the “no vacancy” sign. On a cellular level, the “no vacancy” sign is the first bump in insulin resistance, and that bump will cause an increase in fat storage and a bump upward in cholesterol.

Keep adding traffic, though, and the hotel manager gets more irritated. He is so annoyed that he builds a gate that goes down in front of the entrance to keep cars from entering at all. On the cellular level, this is called the “downregulation of insulin receptors.” In other words, muscle cells reduce the number of insulin receptors available since the cells are full of glycogen, and there’s nowhere to put more.

Once the arms go down—the downregulation of insulin receptors—you’ve reached full-on insulin resistance. This eventually wears out the beta cells in the pancreas, leading to diabetes.

So–Insulin resistance. Not good. But what do you do about it?

I’m glad you asked.

There are a few strategies to regain your sensitivity. To return to the parking lot analogy, you can add more parking spaces and/or (preferably both) decrease the traffic trying to park.

If you decrease calories, you decrease traffic to the hotel parking lot. The calories that make the most sense to decrease are processed carbohydrates–things high in calories but low in nutritional value. I make the case in my books that someone with a lot of fat to lose can cut carbs quite a bit.

In my recent article about zone two training, I mentioned that those with the most mitochondrial dysfunction will have the most difficulty accessing their fat stores for fuel. I had a patient just yesterday who I hadn’t seen in a while and had lost around 50 lbs since I’d last seen him. When I asked him about his strategy for losing weight, he replied, “Walking.”

Walking, especially for someone who hasn’t been exercising, is enough to nudge the body into a much more positive metabolic state. The patient in question told me he gets up early, walks for a while, and then does more at work and lunch, about eight miles a day.

And walking eight miles a day burns about as many calories as running the same distance–it just takes longer.

So, to clear the parking lot, eat less cars, and walk some of them off. Those are the “decrease the traffic” strategies.

My next strategy is to add parking spaces. You can’t add more liver, but you can add more muscle. The best way to add muscle is to lift weights and get stronger. You don’t have to spend hours in the gym to do that. I only lift three days a week, and each session lasts about 30 minutes.

I admit that I push myself hard for those 30-minute sessions, but nothing worth having comes easily, and keeping my strength and resilience as I age is worth an hour and a half a week under a barbell.

The final piece of good news on this subject is that as you empty those parking spots while simultaneously building more, your insulin sensitivity will improve, which means you can eat more carbs to fuel your workouts. I love carbs, so I keep the workouts going.

October is a special month for me because it signals another year in practice. This year it marked my 14th year at this. If you’re thinking that doesn’t seem long enough, given the amount of gray in my hair, it’s because I started doing this as a second career after teaching English first.

When I opened my practice, I was already 40. And now, I’ve been at it long enough to see kids who were coming in with their parents become patients themselves.

I’ve also seen my more adult patients, who were my age now when I met them, age into the Medicare bracket. And I can tell you the ones who are doing the best when it comes to physical health all have one thing in common:

Health and fitness is a part of their identity.

Because of my weight loss books, nearly everyone who’s lost a lot of weight and kept it off talks to me about it. Without fail, they keep it off by finding some form of exercise they like and then doing it regularly. Often, the exercise in question was something they could only tolerate, but with reps, they made it a part of their core identity.

Weight lifting, running, cycling. It’s all fair game. One guy who just came in again after several years away has taken to ultra marathons (100-mile races).

But here’s the cool part: The benefit of going from sedentary to moderately active is huge compared to going from moderately active to very active. You don’t have to devote endless hours to fitness to get the most results. But if you don’t do anything, it’s not good. Check out the graph below:

You definitely want to be on the solid line camp.

But what does it take to get there? As always, it depends on many factors, including genetics, previous levels of activity (muscle memory is a real thing I plan on writing about in the future, but a history of working out is a win), and how active you are at work.

If, for example, you take a complete couch potato who works from a computer all day and get them walking for just ten minutes three days a week, their level of fitness will grow to a degree that will keep them above the dotted line in the graph for years longer than if no changes were made.

The results are even better if you add strength training to the equation. Just a couple of sessions a week of focused weight lifting can add much life to the years of the average Medicare-aged human. You don’t have to subscribe to Olympic levels of training to get results. But you do have to start.

I recently went to the funeral of an old friend from high school. It was the first time I’d been around many of my old high school friends in years, and I wanted to shake them by their lapels and beg them to do the basics.

Not smoking and not drinking too much is not enough. You have to challenge the system. But if you do, you’ll find that the second half of your life can be as rewarding as the first.

Until next time,

Doc G

P.S. I added creatine to my “poor man’s Ozempic” because some solid research shows an increase in cognitive function, and I’m always looking to keep my edge in that regard. But this weekend, at 54 years old, I set a new personal best on the bench press, so clearly, the tried-and-true strength gains creatine is known for are coming.

That’s right–today (Saturday, Sept 28th) makes 1,000 days since my last drink. For over two and a half years, I’ve dodged the booze bullet but have still gone to concerts, sung karaoke, and even released a solo album of original songs on which I played all the instruments and recorded the whole thing at home on my lunch breaks.

Now, I’m not saying I was an alcoholic and just had to stop before bad things happened. However, during the COVID phase of 2020 and 2021, I started drinking more out of habit than any other reason, and that’s not a habit I felt good about.

I’m also not saying that list in the first paragraph wouldn’t have happened had I been drinking–but I think I can say that I’ve been more productive in this last 1,000 days than I would have been otherwise.

I once took a year off from drinking (in 2017), and it was an excellent year for my business and health. So, I was hopeful that this break would yield similar results. This time, I planned on taking a year off and then reassessing.

And man, that year went by fast. My sleep improved significantly, I was lifting heavy in the gym, and I lost weight in the process. The more I thought about it, the more I realized that I just wasn’t ready to start back up. So, I decided on another year.

I’ve been enjoying being more present in my daily interactions with my patients and friends here at the office. My guitar playing has improved dramatically, and there’s always something to think about or handle with the spa business (in case you don’t know, my wife and I own Hand and Stone Oak Forest right around the corner).

So, here we are—1,000 days dry. Although there is still an occasion here and there where a drink sounds good—mostly at nice restaurants and such—but when the moment passes, and I’m driving home, I’m always glad I skipped the sauce. And I’m even more happy about that decision the next day when I get up ready to rock. At this point I have so much inertia not drinking that it would take more effort to start again than it does to stay on the train I’m on.

I can’t say I’ll never have another drink, but for now, I will keep on this path. I wrote more about this subject at the end of my first year, and you can read about that here.

Thanks for reading, and have a great weekend.

Doc G

P.S. I had multiple people ask what the actual recipe is for the Poor Man’s Ozempic I wrote about recently (it was a very popular article), so I updated the post to add the exact measurements of everything. I also put the three ingredients together in one place to make it easier to see/find.

I typically gain a few pounds during the winter and then spend spring trimming back down for my July birthday, where I do nothing because it’s too hot outside. But in my mind, I will have a pool party every year, so I start trimming down for the imaginary birthday bash that never materializes.

This year, I got a late start on the trimming down part of the tale. There were a few reasons, like crazy storms and the fact that my bench press is better when I have a few extra pounds on me. I’m trying to stay ahead of my son, who is now taller and heavier than me.

But I finally decided to tighten back up. This time, I’ve incorporated a secret weapon: my “poor man’s Ozempic,” known as my nightly Sludge.

The Sludge has three ingredients: psyllium husk fiber, collagen, and creatine. I call it “poor man’s Ozempic” because of the mechanism of action for Ozempic: increased satiety (feeling full) decreases appetite.

Ozempic delays gastric emptying, which in turn helps one stay full for longer. It has other mechanisms of action, too, but hunger is the enemy of weight loss, and reducing hunger is the primary way it works.

And nighttime after-dinner snacking is my enemy. Enter–The Sludge.

There are several reasons for the mix of the three ingredients. Let’s break them down individually.

Psyllium husk is the most essential of the three because it’s essentially liquid fiber. Fiber is good for the gut microbiome, increases satiety, and even helps reduce cholesterol. Once in your system, psyllium becomes a gel-like substance that increases the bulk in your GI system. That extra bulk increases the feeling of fullness, which keeps me out of the pantry after dinner. For more about psyllium, read this helpful article.

I should also mention that psyllium is the active ingredient in Metemucil, so it can also help with constipation.

Next, in order of importance, is collagen. Collagen is protein, and protein is also highly satiating. In my books on weight loss, I encourage eating more protein and fiber to win the war against hunger; this concoction is an easy way to do that.

Collagen can also increase skin elasticity and help lubricate joints as you age. I’ve been taking it for many years, but I’ve been more consistent since I hit my 50s. The list of things collagen supplementation can help with is pretty awesome. There are even studies showing supplementing can help with bone density.

To complete the trifecta, I add creatine to The Sludge. Creatine is well-known for its muscle-building effects. It helps your mitochondria regenerate ATP more quickly, enabling you to knock out those last few demanding reps when you’re working hard. Adding reps over time helps build strength and muscle density.

However, more and more studies show that creatine also has cognitive benefits. I’m always looking for ways to keep my edge and age gracefully, so a supplement that helps my muscles and brain is on the list of molecules I’m willing to pay for. And, bonus, creatine is pretty cheap. For a quick video review on creatine, watch this short video.

Put it all together, and this nightly concoction helps keep me from late-night snacking, lowers my cholesterol and blood sugar, fuels tissue repair, and increases muscle growth and cognition. The dosage is one tablespoon each of the collagen and fiber and a scoop (5 grams) of the creatine.

If you’re interested in trying this for yourself, I added the three base ingredients to my Fullscript store–all the basics are under “Doc G’s Monthly Supplement List.”

Win some, lose some…

In my last post, I talked about my fitness triumphs—things I’m glad I’ve done over the last 10-15 years to age as gracefully as possible. Today, I’m not going to be so nice to myself. We can all improve, and maybe reading my regrets will spark action for you so you don’t have similar regrets yourself.

My number one regret is avoiding cardio like the plague for way too many years than I’d like to admit. When I was younger, I played tennis and surfed whenever there were waves. But since I’ve been married (22 years now!), I don’t get to the beach nearly as often as I used to except when I was in chiro school and lived two blocks from the ocean. That was pretty sweet.

I regret this mistake because I wasted time that I could have used to improve my heart health. I was erroneously conflating body composition with health. I was decently lean and muscular, so I figured I was good.

But my family history says otherwise. My dad had to have an emergency heart surgery that almost killed him a few weeks after competing in a bodybuilding competition. He’s a walking medical miracle today, just because he lived after spending a solid month in the ICU in what was essentially a coma.

And he was leaner than I’ve ever been leading up to that show.

But did I get busy with heart-friendly exercise after all of that? No. No, I did not. I blamed Dad’s issues on him getting pretty heavy in his 50s and figured that’s when he did the damage. I wasn’t going to do that, so I thought I was good.

But then, in my late 40s, I sent myself for a coronary calcium scan, which is a CT scan of the heart that will show calcifications in the arteries that bring blood to the heart itself. And, low and behold, I had some calcification, which is consistent with arterial plaque buildup.

After an initial freakout, I assessed my options. And, my friends, it became apparent. Imagine a medication that would improve every health metric you can think of–sleep, resting heart rate, blood pressure, cholesterol, cognition, and more (including slowing the progression of arterial calcification).

You’d want to take that medication, right? Well, now imagine that you have to put in a couple of hours of exercise a week to qualify to receive it. Most of us would still want it. And the rub, of course, is that the exercise is the medication.

But if I had only started taking my medicine years ago, when I was in my 20s instead of my 50s, I would be so much better off today. Still, there are plenty of benefits to get, even starting now. Everything from that list of benefits above is my current experience. But, still. Dangit.

So, if you’re younger, let my hindsight be your foresight. Start doing some form of cardio. The single best metric for predicting longevity is your VO2 max, and the only way to get that number up is by consistently working your heart at the top of its range. This video gives more detail about improving your max (including defining it).

If you want to learn how to measure your VO2 max, this video shows a couple of dudes doing just that at a lab and then comparing the numbers their Apple and Garmin watches got. And this video shows some other ways to measure if you don’t have one of those fancy watches.

If you’re older, the best time to start is 30 years ago, but the next best time is today. Even upping your step count by walking a few miles daily can help. And if you really want to make some changes, I suggest finding a group exercise class to join.

The research shows that adherence to a program is the most critical piece of the puzzle when making the changes I’ve been writing about. People are typically more likely to keep showing up when there’s the added benefit of seeing a friend or two when you get to the class—and then suffering together.

I have more regrets than this, but the lack of cardio is far and away my biggest one, so I’ll stop here for now.

My annual thoughts on aging well

Birthdays always make me look back on the last year and ahead to what’s to come. I’m writing a two-part series on the things I’ve done, both right and wrong, regarding healthy living. 

Since today (Saturday) is my birthday, I’ll be generous with myself and talk about the good stuff. It’s a short but profound list.

First, I’ve lifted weights steadily since I was in my mid-20s. I started for vanity, but now I’m doing it for the increased health span. One of the most significant detriments to our health as we age is sarcopenia, the age-related decline in muscle mass. However, research shows that lifting weights can keep your muscles and strength well into your elder years.

I recently set a personal best on bench press, and I’m definitely not getting any younger, so I feel good about that.

Next–I stopped drinking two and a half years ago. I know that’s a massive deal for many people, and I’m not here to try and convict you about your choice in the matter, but I wrote about it at the one-year mark here, so check it out if you want to hear that story.

Two years ago, I started seriously doing cardio. I’ve written about that here and here. Adding cardio to weight training has made me feel younger than ever.

Regarding supplements, I’ve maintained healthy vitamin D levels all these years. I’ve also been taking a magnesium supplement for about 15 years now. Magnesium prevents DNA replication errors when cells divide, a significant part of cellular aging. For a deep dive into magnesium supplementation, watch this video (it’s long but worth it if you like to geek out on this stuff like I do).

Also, since about 2016, I’ve been taking a collagen supplement, and I’ve been consistent with it for the last few years. In the last two years, I’ve been adding psyllium husk to the collagen (I call it my “nightly sludge”), which keeps me from overeating, lowers cholesterol, and regulates the ol’ GI tract. And lately, I’ve been adding creatine to the sludge for a triple threat of benefits. 

Creatine deserves its own post, which I’ll do shortly. Here’s a short video to whet your appetite. The benefits extend far beyond the strength training stuff most people think of when they think about creatine.

One final thing on the “things I’ve done right” list is getting my sleep schedule down better than ever. I’ll admit I spent too many nights staying up too late in 2019 when my wife and I were singing karaoke twice a week at the dive bar down the street, but right around that time, I read Matthew Walker’s book on sleep and decided to make some changes. I’m glad I did. Watch this video to get a taste of what he says about the subject.

My next post will be on my list of fitness regrets. Check back soon.

I have good news for anyone who wants to start their fitness journey. And, bonus, the good news also applies to people who’ve already made exercise a part of their journey. The good news is that we should all be doing more Zone 2 training. 

Zone 2 has become a massive buzzword in the fitness world over the last few years, especially after Peter Atilla’s book Outlive came out last year. I wrote about it here, but the book is a handy guide to all the lifestyle and medical interventions that one can incorporate into their routines to give one the best chance at living a long and healthy life.

Atilla also has a podcast called The Drive, where he dives deep into many of the book’s topics, including several on Zone 2 training.

So, let me get to the point and tell you what Zone 2 is and why you should do some of it.

The technical definition of Zone 2 training is the rate of exertion that keeps lactate between 1.7 and 1.9 mmol. But that’s hard to measure without a lab, so today, we’ll use the “talk test” to help you know if you’re in the correct zone. 

To do the talk test, you just have to work (walking, running, or biking are excellent choices for testing) at a rate where you can still have a normal conversation but might sound slightly out of breath. Easy.

But why would you want to spend 80% of your cardio time (the recommended amount) going so low and slow? Because Zone 2 is the best way to enhance the function of something you haven’t thought of since 9th-grade biology: mitochondria (the power plant of the cell, remember?).

Mitochondrial health is one key to living a long, healthy life, and if that’s not good enough, it’s also the key to being an efficient fat burner. Those with the best mitochondrial health will burn more fat at rest and during exercise than those with less efficient mitochondria. And the more Zone 2 training you do, the more efficient your mitochondria will be.

Ironically, this means that well-trained athletes will be in fat-burning mode most of the time, while people with much more fat to lose will have a much harder time accessing those stores for fuel. 

To add insult to injury, the more glucose you burn (the alternative fuel to fat), the higher your lactate levels will rise, which leads to the burning in the muscles associated with a hard workout.

If you’re wondering why I kept saying this is all good news, here’s the good news: If you’ve been putting off exercising because you have a “go hard or go home” attitude, you can shift your thinking to “go easy to get better” instead.

When I got the Peloton bike, I kept doing shorter, intense rides that beat me up. At first, it was fun because I kept seeing improvements from ride to ride.

Eventually, I hit a plateau, and the only way to beat my previous day’s metrics was to go all out. And going all out every day is a recipe for injury. Getting my mind right about getting on the bike was also challenging.

But then I learned about Zone 2, and today, I ride longer and more frequently than ever but at a much lower intensity. I wrote more about my Peloton Zone 2 experiment, and you can read about that here. But this is already getting too long, so I’ll stop for now (although I just reread the title of that article and chuckled, so you should, too).

Go here if you want to get more into the details than I did. There’s even a video interview between Attila and one of the world’s master cycling coaches, and they talk about Zone 2 throughout the conversation.

What do brisket and cardio have in common?

I’ve good news if you’re considering starting an exercise program. And I’ve got bad news if you’ve been making excuses about beginning an exercise program. The news is the same: low and slow is the answer to the question above when it comes to best practices. Mostly. As usual, it’s complicated, but this is the simplified version.

Allow me to introduce you to the concept of “zone training.” Zones are heart rate zones, and training in the second lowest zone, zone 2, is a huge advantage. There are five to seven zones, depending on who you read. Peloton uses seven (and most cycling apps do, too), whereas other sports tend to use either five or six. A six-zone breakdown would look like this:

• Zone 1
  • Energy source mainly used: fat
• Zone 2
  • Energy source mainly used: fat trending into carbohydrates
• Zone 3
  • Energy source mainly used: fat trending into carbohydrates
• Zone 4
  • Energy source mainly used: carbohydrates
• Zone 5
  • Energy source mainly used: carbohydrates
• Zone 6
  • Energy source mainly used: carbohydrates trending into creatine phosphate

The easiest way to know you’re in zone 2 is the “talk test,” where you could have a normal conversation while working out, but the person you’re talking to would know you’re doing something more challenging than couch surfing. Zone 2 will have you in a heart rate range of 60-70% of your max. 

To determine your max heart rate is a moving target, but the classic formula is 220 minus your age. While writing this, I looked at my max heart rate for a hard bike ride, and I hit 164 BPM at the peak. 220 minus my age is 167, so the formula works well for me.

But here’s why you want to stay in zone 2: mitochondrial health. You remember ol’ mitochondria, don’t you? The powerhouse of the cell? This is a good place for a meme:

Here’s what you need to know–mitochondria make energy, and zone 2 training helps you make more mitochondria. So, doing more low and slow zone 2 training will eventually increase your ability to go all out. 

A helpful way to think about it is that adding more mitochondria to your system by going low and slow is like building more turbochargers into your muscles. Once you get enough, going faster is much easier.

This entire concept contradicts most people’s intuition (including mine).

I only went hard for short, intense rides when I started using the Peloton. And I made a lot of progress doing that. But going all out all the time has risks. It’s a lot easier to hurt yourself, for one thing. And it takes a certain amount of willpower to go for it every time you get on the saddle.

Then I got hip to zone 2 and started taking longer, much slower rides. I’ll admit that it’s harder to find the time (45 minutes is the recommended lowest time necessary to get the benefits), and I’m still getting used to that amount of time on the saddle (padded bike shorts have helped). 

Peloton has a test you can take (the FTP test) where you go all out for 20 minutes to determine your zones. Once you take the test, you get a meter on the bottom of the screen that shows you what zone you’re in at any given time.

I started reading more about zone training after taking the test for the first time. So, I did an experiment and did much longer and slower rides for about three months and then retook the test. 

Keep in mind that most of my shorter, more intense rides were in the 15-20 minute range. When I’d hit a personal best, it would be by only a point or two (and by “point,” I mean kilojoules, the total output metric used by Peloton).

When I retook the test, I set a new personal best by 20 points. That’s a lot for me. And the best part was that I wasn’t killing myself doing the training to retake the test. Low and slow. Like smoking a brisket.

So, if you’re worried about getting started and all the pain and soreness that usually accompanies beginning an exercise program, think zone 2. For most relatively deconditioned people, that usually looks like a decent walking pace. Having a heart rate monitor will be helpful to keep yourself in the correct zone. The Apple Watch has that kind of thing built in, as does the Fitbit. There are plenty of other options for cheap on Amazon.

And to be clear, I still lift weights 3-4 times a week, and you should, too. But I knew I needed to add cardio to the equation for the many health benefits. Another point of clarification is that even though zone 2 is in the “fat-burning zone,” the goal should not be to try and burn off extra fat stores through cardio. 

Fat loss is more about diet. Zone 2 training will burn calories, but your main focus is increasing your overall metabolic health. Those with more mitochondria working for them will have better insulin sensitivity and lower resting heart rates, which means your heart won’t work as hard throughout your lifetime and will last longer.

And I still do some shorter, more intense bike runs, too. But I’m going for the 80/20 split, with 80% of my rides being longer. Getting a fierce 15-minute ride now and then is fun, and they feel like they go by super fast after doing the longer ones most of the time.

I hope you found this helpful.

Until next time, 

Doc G.

If you’ve been a part of my world for a while, you may remember back in 2017 when I took a year off from drinking. It was an experiment to see how much my life might change by abstaining from alcohol while trying to get in the best shape of my life. And it worked–maybe even a little too well, as people constantly asked me if I was okay since I got too lean in the face.

Anyway–the 2017 experiment showed me that eliminating alcohol was totally doable and had many benefits. So, to map out my “booze trajectory” after that for you–my intake in 2018 was very low. Almost zero, but I did enjoy a few glasses of fancy red wine and had one beer on New Year’s Day.

In 2019, I increased my intake because there’s a dive bar at the end of my street with karaoke a couple of nights a week, where we practiced our singing chops. So, I bought drinks to support the bar. But it was the karaoke that I was there for, not the booze.

Then came Covid. Can I get an amen? We closed at lunch every day for the first several months of that vile plague. So I’d go home, work out, walk the dogs, go for a swim, and it would be, like, three o’clock.

And three o’clock during prime time Covid was about an hour past many people’s happy hour. So, we started making cocktails and watching the doom n’ gloom daily news reports, which, upon looking back, wasn’t the best idea I’ve ever had.

And that trend continued (minus the news reports) through 2021. And you know what goes great with a cocktail? A snack, that’s what. Although I was working out, maybe even more than usual, all the extra crackers and cheese calories were catching up to me. The adage, “You can’t outrun a bad diet,” held true. And I wasn’t even running.

So–as 2022 approached, I decided to jump on the wagon again. And, for now, I’m still on it. Just over 600 days dry as of this writing.

But let me tell you the most significant advantage that came with complete abstinence: the conversation in my head got way more productive.

Let me explain. When the Covid consumption happened, I noticed that my entire drive home (it’s only eight minutes, but still) was me talking to myself about not starting too soon, drinking too much, taking a day off, setting rules around it, and more.

And then, I’d walk in the door, go into “habit mode,” and do it all over again regardless of whatever plan I had made on the drive. And every morning, I’d beat myself up about it again and start the conversation anew every afternoon.

Wash. Rinse. Repeat.

So, by simply not doing it, I freed up some of the ol’ CPU to plan, think about improving some other aspects of my life, or even daydream. As a result, many good things began to happen as I removed all the guilt from my routine and started focusing on pretty much anything else.

Then, the year came to an end. But I wasn’t ready to try again. But at least it was “dry January,” so I was joined by thousands of others who were trying to start the new year off right.

And now, 20 months dry, I have no intentions of returning to drinking. The benefits far outweigh the occasional pang of “missing out” on a moment when a drink would seem nice. And I’m always happier the next day for having skipped the beverage.

Also, alcohol was classified as carcinogenic in 1988, and its ability to damage one’s liver is no secret. Now that I’m on the backside of 50, I’ve been thinking a lot more about enhancing my health span in every way possible. Dropping alcohol has so many positive health effects that I can’t justify doing it anymore.

I’m still having fun and being productive. I’ve been working on new music and setting personal bests working out. And I’ve discovered the world of NA beers, some containing nootropics such as ashwagandha to help with relaxation. But at this point, it would feel like I was taking a huge step backward to drink again.

Of course, your mileage may vary. But I hope my experience may be helpful when it comes to thinking about your own drinking.

I just had another birthday, and anyone over 50 will tell you that once you cross that particular milestone, it’s common to start thinking about ways to ensure the back nine of your lifetime will be fulfilling and not spent in doctor’s offices. And because it’s a part of my professional life, I thought about it long before my 50s.

Here’s the sad truth, though: most people these days, according to the stats, are going to have a tough time with the second half of their lives unless they start the fight. The best time to start that fight was years ago, but the second-best time is now. Today.

I just finished reading the book I wanted to write (and I may still write my version if I can only find the time): Outlive, by Dr. Peter Attia. In Outlive, Dr. Attia outlines “the four horsemen of chronic disease”: diabetes, cardiovascular disease, cancer, and dementia. These four broad categories lead to the death of 80% of non-smokers over 50.

Attia’s approach to the four horsemen is prevention. And as I said above, the best time to start is years ago. I don’t want to rewrite his book here, but some of the highlights involve exercise, both cardio and strength training. He’s also big on the prevention and maintenance of orthopedic injuries (such as back, neck pain, and knee pain) that lead to our moving less, which in turn leads to deconditioning and, eventually, frailty. Of course, I’m here to help with the ortho injuries.

Here’s the sad truth about muscle: we need it badly. We lose it as we age at the rate of 3-5% per decade of life starting at age 30. The average octogenarian has about 30% less muscle than they did in their youth. That muscle loss can lead to falls, often deadly to older adults.

The good news is that the literature is replete with studies showing that strength training can help you build muscle for decades and maintain what you have even longer. And you can get much stronger than you think. But that’s not what’s happening to our society as a whole. Grip strength, for instance, has been steadily declining for decades. And grip strength and mortality are closely connected.

Another thing Attia talks about is “molecules” that can help fight the rising tide of aging. Many of the molecules in question are cholesterol-lowering drugs. He doesn’t get into supplements much, but a quick search reveals several articles detailing what he takes and why, which almost mirrors my list (that link will take you to my brand new online dispensary, Fullscript, where you can see my list and order other supplements, too. As always, feel free to message me with questions).

As I’ve mentioned, one of the significant changes/additions to my exercise program was the addition of the Peloton bike. I love how data-heavy the app is. It’s motivating to see the constant adaptations happening, and as I type this, I had another personal best just yesterday.

I swore I would add more (ok, any) cardio to the routine when I turned 50, but that event went down in 2020, and I found plenty of excuses not to do it that year. And 2021 could have been better, too. I found a lot of reasons to drink too much that year, though.

And that leads me to one of the most significant decisions I made to improve my health going into 2022–I decided to take a year off from drinking alcohol. And I haven’t looked back. I will write about that soon, as a profound change of that magnitude deserves its own post.

Here’s the bottom line with all of this: you’ve got to fight. Only you can fight the battle against the aging process for yourself. You can learn strategies from doctors and coaches, but you must do the work. You can have all the money in the world, but if you don’t have fitness, you don’t have the one thing money can’t buy.

You should buy Attia’s book and start your journey.